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| Public Act 103-0030 | ||||
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Insurance Code is amended by | ||||
changing Section 356u as follows:
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(215 ILCS 5/356u)
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Sec. 356u. Pap tests and prostate cancer screenings.
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(a) A group policy of accident and health insurance that | ||||
provides coverage
for hospital or medical treatment or | ||||
services for illness on an
expense-incurred basis and is | ||||
amended, delivered, issued, or renewed after January 1, 2024 | ||||
shall provide coverage, without imposing a deductible, | ||||
coinsurance, copayment, or any other cost-sharing requirement, | ||||
for all of
the
following:
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(1) An annual cervical smear or Pap smear test for all | ||||
female insureds.
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(2) An annual prostate cancer screening for male | ||||
insureds upon the recommendation of a physician licensed
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to practice medicine in all its branches for:
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(A) asymptomatic individuals men age 50 and over;
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(B) African-American individuals men age 40 and | ||||
over; and
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(C) individuals men age 40 and over with a family | ||||
history of or genetic predisposition to prostate | ||
cancer.
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(3) Surveillance tests for ovarian cancer for female | ||
insureds who are at risk for ovarian cancer. | ||
(b) This Section shall not apply to agreements, contracts, | ||
or policies that
provide coverage for a specified disease or | ||
other limited benefit coverage.
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(c) This Section does not apply to coverage of prostate | ||
cancer screenings to the extent such coverage would disqualify | ||
a high-deductible health plan from eligibility for a health | ||
savings account pursuant to Section 223 of the Internal | ||
Revenue Code. | ||
(d) For the purposes of this Section: | ||
"At risk for ovarian cancer" means: | ||
(1) having a family history (i) with one or more | ||
first-degree relatives with ovarian cancer, (ii) of | ||
clusters of women relatives with breast cancer, or (iii) | ||
of nonpolyposis colorectal cancer; or | ||
(2) testing positive for BRCA1 or BRCA2 mutations. | ||
"Prostate cancer screening" means medically viable methods | ||
for the detection and diagnosis of prostate cancer, including | ||
a digital rectal exam and the prostate-specific antigen test | ||
and associated laboratory work. "Prostate cancer screening" | ||
includes medically necessary subsequent follow-up testing as | ||
directed by a health care provider, including, but not limited | ||
to: | ||
(1) urinary analysis; | ||
(2) serum biomarkers; and | ||
(3) medical imaging, including, but not limited to, | ||
magnetic resonance imaging. | ||
"Surveillance tests for ovarian cancer" means annual | ||
screening using (i) CA-125 serum tumor marker testing, (ii) | ||
transvaginal ultrasound, (iii) pelvic examination.
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(Source: P.A. 102-1073, eff. 1-1-23.)
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Section 99. Effective date. This Act takes effect January | ||
1, 2025.
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